[Question #3957] Follow up to: [Question #3941] Concerned over possible risks of HIV/HEP C over n

85 months ago

Dear Doctor,

Thank you so much for giving me positive encouragement about my risks. My mind plays a lot of trick on me, and for assurance sake I thought of taking a test. It is 37 days post my exposure to last blood draw (4 June 2018). If I take a CMIA ag/ab test on 37th Day, can I take this as conclusive?

Please forgive me for the silly questions - but this is really driving me crazy.

Thanks!

Edward W. Hook M.D.

85 months ago

Welcome back to the Forum although I must say I'm sorry you felt the need to return after your interaction with Dr. Handsfield. I have reviewed your earlier interaction with him and agree with all that he has said. A combination HIV antigen/antibody test taken 37 days after your blood was drawn earlier would detect well over 99% of HIV infections but would not be considered completely conclusive until 42 days (six weeks) afterwards. In your case, the chance that a 37 day test would miss an infection is virtually non-existent.

I hope that with this advice you will be able to move forward without continuing concerns. I agree with Dr. Hands field's sense that you are overthinking your risks. EWH

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85 months ago

Dear Doctor,

Thank you so much for responding to my questions. I truly appreciate all help and support am getting from you and Dr. Handsfield.

I went ahead and took a few blood tests on day 38 post my last blood draw (The blood draw event that I fear needle reuse). The results are as follows:

HIV Ag/ Ab Screening (CMIA) : Non-Reactive

Anti-HBs : >1000 mIU/ml

Note : Immune.

HBsAg (CMIA) : Non-Reactive

Anti-HCV Screening : Non-Reactive

Based on the above results, I do have a few questions. Very much appreciate your time and effort to answer them:

Based on the above results, which are based on test taken 38 days after last blood draw - do you sense a need for me to repeat another test after another 4 days?
Based on the above results, do you feel I can confidently resume unprotected sex with my wife?
What would be the likely hood of the result being a false-negative, considering that I have taken the test 4 days before the 6 weeks mark? I checked with the lab, they said the test they did for me is a 4th Generation Test and Window Period for 4th Generation Test is 3 months.
I also visited a Dermatologist, and the moment he saw my rash he told me that this is URTICARIA. Is urticaria a symptom to be concerned about for HIV? He did a few allergy tests and found that my Total IgE is very high (224). Range is below 85. Would this impact the results above?

Thank you doctor!

Edward W. Hook M.D.

85 months ago

Based on the above results, which are based on test taken 38 days after last blood draw - do you sense a need for me to repeat another test after another 4 days?

I did not think you needed testing to begin with. I do not think you need further testing.

2. Based on the above results, do you feel I can confidently resume unprotected sex with my wife?

Yes

3. What would be the likely hood of the result being a false-negative, considering that I have taken the test 4 days before the 6 weeks mark? I checked with the lab, they said the test they did for me is a 4th Generation Test and Window Period for 4th Generation Test is 3 months.

I would not be worried at all about false negative results. The chance that your test is false negative is a small fraction of 1% and given the virtually no risk nature of the event you are concerned about, I would not be worried at all.

3. I also visited a Dermatologist, and the moment he saw my rash he told me that this is URTICARIA. Is urticaria a symptom to be concerned about for HIV? He did a few allergy tests and found that my Total IgE is very high (224). Range is below 85. Would this impact the results above?

No to both questions.

I continue to believe that you are worrying needlessly. I hope my answers will help you to move forward without concern. EWH

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85 months ago

Dear Doctor,

Thank you once again for giving me useful and helpful insights to relieve me from this horrible anxiety that I am going through. I have two more questions, which I hope you can help explain/address:

Are all 4th Generation Tests conclusive at 6 weeks and 99% accurate at 4 weeks? The lab told me it is 3 months window period and they did not tell me what equipment was it except for the test: CMIA. You mentioned that I do not require further testing and false-negative is something I don't have to worry about, given that it is a fraction of 1%. From a medical/scientific facts point of view, and in the circumstances that I am in, would the test have definitely picked up an infection at 37 days post blood draw (exposure)? Has there been anyone testing negative at 4 - 5 weeks, suddenly appearing positive at 6 weeks and above (IF THERE WAS NO OTHER EXPOSURES IN BETWEEN).
I am hearing mixed feedback about HIV test conclusiveness can take up to 12 months for patients with Hepatitis. I did do the Hepatitis test as in my previous query to you and it was also non-reactive. For knowledge, may I understand if HIV test results do get impacted with Hepatitis? Appreciate your medical viewpoint on this whole confusion about testing.

Thank you for your feedback.

Edward W. Hook M.D.

85 months ago

Your follow-up questions are repetitive. Repeating your questions will not change the answers. Final answers:

1. Your lab is being overly conservative. Combination antigen/antibody tests are conclusive at 6 weeks. Conclusive means just that, not that some persons become positive after six weeks.

2. By "hearing" I suspect this misinformation is something you found on the internet. It is incorrect. with your test results there is no reason to worry about hepatitis and even if you did have hepatitis, there are no data that suggest that hepatitis changes the performance of HIV tests.

This is my 3rd response to your questions. I trust it will be your last. This thread will be closed in a few hours and should you post further repetitive, anxiety-driven questions, your questions may be deleted without response and without refund of your fee. You need to move on and stop worrying. EWH

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